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Abstract

For decades, the dominant view among biomedical ethicists, transplantation professionals, and the public at large has been that altruism, not financial considerations, should motivate organ donors. Proposals to compensate sources of transplantable organs or their survivors, although endorsed by a number of economists and legal scholars, have been denounced as unethical and impracticable. Organ transplantation is said to belong to the world of gift, as distinct from the market realm. Paying for organs would inject commerce into a sphere where market values have no place and would transform a system based on generosity and civic spirit into one of antiseptic, bargained-for exchanges. Here, Mahoney discusses a brief history of the restriction on payments to sources of transplantable organs. She then turn to the arguments commonly advanced against compensating organ sources and explain how they are grounded in beliefs that range from the highly contestable to the demonstrably wrong. Furthermore, she examines the most popular compensation proposals, and offering preliminary assessments of their promise and feasibility. She also concludes with some thoughts about the relationship between altruism and self-interest.